Hypertension (aka high blood pressure) is a serious medical condition characterized by persistent elevations in blood pressure. The pressure that’s measured when the heart contracts to pump blood is systolic blood pressure, which is the top number in a blood-pressure reading. Meanwhile, the bottom number is the diastolic pressure, which is the amount of pressure in the blood vessels when the heart relaxes. Let’s face it, a hangover in your mid-40s doesn’t feel the same as one in your early 20s.

1. Sierksma et al.131 identified a U-shaped relationship between alcohol consumption and the aortic pulse wave velocity.
2. The Global Action Plan for Prevention and Control of NCDs, by the World Health Organization (WHO), calls for a 10% relative reduction in harmful use of alcohol between 2013–2025 20.
3. “If it is realistic for you, a good practice is limiting daily alcohol consumption to one or fewer standard drinks,” Dr. Tsay says.
4. Beilin et al.88 reported a decrease in the resting BP of Wister Kyoto and SH rats after 12 weeks of ethanol administration (20% in drinking water), although cardiovascular reactivity to noise-related stress was augmented in the ethanol-fed SH rats.
5. As with isolated animal heart experiments, some investigators have found that acute alcohol exposure (blood alcohol levels 40 to 110 mg%) depresses myocardial systolic function in humans (Delgado et al. 1975; Lang et al. 1985; Timmis et al. 1975).

This supports the findings from other studies that the alcohol-induced changes in HDL-c do not fully account for the lower risk of CHD in moderate alcohol drinkers (Mukamal 2012). High triglyceride levels in the blood stream have been linked to atherosclerosis and, by extension, increased risk of CHD and stroke. Alcohol consumption has been shown to have complex, and sometimes paradoxical, associations with cardiovascular diseases (CVDs). Several hundred epidemiological studies on this topic have been published in recent decades. Methodological shortcomings, such as exposure classification and measurement, reference groups, and confounding variables (measured or unmeasured) are discussed.

This is why the Dietary Guidelines for Americans suggests that adults who do not drink alcohol should avoid starting, if possible. One way alcohol raises blood pressure is by stimulating the sympathetic nervous system and the release of adrenaline. This is particularly true with excessive drinking behaviors, such as binge and heavy drinking. Drinking alcohol to excess can cause other serious health conditions, such as cardiomyopathy (where the heart muscle is damaged and can’t work as efficiently as it used to) and arrhythmias (abnormal heart rhythms). The alcohol industry has also perpetuated misleading information about the benefits of drinking alcohol.

In a meta-analysis of 11 cohorts published in 2014, an inverse risk relationship between average alcohol consumption and IHD in patients with hypertension was reported 37. Similar associations have been reported among people with diabetes and non-fatal myocardial infarction 38,39,40,41,42. A recent large-scale study from the UK reported a J-curve for most CVD outcomes in patients with CVD 43. More contemporary studies have not found evidence of mitochondrial injury in biopsy samples from long-term alcohol drinkers (Miró et al. 2000). Differences among results from human studies may relate to small sample sizes, duration of drinking, and degree of myocardial dysfunction.

Epidemiology and burden of alcohol use

Using a crossover design, Puddey et al.69, 70 compared BP values during a 6-week period of unrestricted alcohol consumption and that of alcohol restriction in normotensive and hypertensive subjects. A 2022 study notes that while some evidence indicates a potential cardioprotective benefit of light to moderate alcohol intake, these benefits may instead relate to other factors. It also notes that excessive alcohol intake could also increase the risk of coronary artery disease (CAD) and heart attack. A 2022 study showed a link between moderate drinking (eight to 16 drinks per week) and a lower risk of type 2 diabetes, but specifically among people who drank alcohol with meals. Many short-term trials that randomly assign people to drink either alcohol or a nonalcoholic beverage show lower blood sugar levels and better insulin sensitivity among people who drink moderate amounts of alcohol. While these biomarkers aren’t a perfect representation of diabetes risk, they’re pretty close, says Dr. Mukamal.

Among these is the activation of mitogen-activated protein kinases (MAPK) signaling cascades. There also is desensitization of the mitochondrial permeability transition pore, which can mitigate ischemia−reperfusion injury (Walker et al. 2013). In addition, alcohol may attenuate ischemia−reperfusion injury by activating protein kinase C epsilon (PKCε) (Walker et al. 2013). Activation of PKCε may protect the myocardium against ischemia−reperfusion injury by stimulating the opening of mitochondrial ATP-sensitive potassium channels. This in turn prevents the opening of the mitochondrial permeability transition pore (Walker et al. 2013).

Can You Reverse Damage to the Cardiovascular System?

Several studies have reported an elevated risk for both IS and HS from heavy episodic drinking 77,78,79. One study showed that the risk increased with a higher frequency of heavy episodic drinking 78. The higher the alcohol consumption within 24 h or one week, the higher the risk for IS or HS 53,80. The way in which alcohol consumption has been measured and categorized varies, sometimes making it challenging to compare data among studies. More studies today report alcohol consumption in terms of either “drinks” or grams/units of ethanol per famous fetal alcohol syndrome day or week, and alcohol consumption is measured by self-report. Most investigators also define the amount of alcohol that constitutes a “standard” drink as 12 to 15 g (with only slight variation).

Should people with heart conditions avoid alcohol?

And sure, we’ve all had a night here or there where we’ve had one too many and we know it. But it’s important to make sure those nights of overindulgence are the exception and not the rule. If you’re not sure, make a note to tune into how much you’re having over the course of the next month or so. If it’s more than recommended, try to consciously pace your drinking to help reduce the spike in your blood pressure that excessive alcohol causes. While moderate amounts of alcohol can offer some heart benefits, too much can have damaging effects.

Controlling Your Blood Pressure

A recent review summarized a number of these studies, showing that alcohol ingested before a meal has frequently been shown to have a neutral effect on intake, or to increase intake, despite the added energy that come from the alcohol preload 5. In these studies, alcohol appears to have no effect on appetite, or to increase appetite 5. However, to date there have been few intervention studies conducted to experimentally examine the effects of regular alcohol intake on weight gain or obesity in humans.

Alcohol has been ascribed as a crucial factor in deaths due to infectious diseases, intentional and unintentional injuries, digestive diseases and several non-communicable diseases (NCD) 7. Exercise can also boost HDL cholesterol levels, and antioxidants can be found in other foods, such as fruits, vegetables and grape juice. This article does not contain any studies with human or animal subjects performed by any of the authors. Taken together, alcohol causes various changes in the autonomic nervous system and endocrine system, but these changes do not seem to have a major role in the pressor or depressor effect of alcohol except in the case of alcohol withdrawal syndrome. After a person undergoes heart surgery, it is best to ask the doctor how much they should drink, as this could depend on individual circumstances and medical history.